CELL BLOCKING General processing of samples

* Involves the preparation of cells by histopathologic 1. Agitate the fluid slightly and pour into test tubes.
procedure 2. Centrifuge at medium speed for 15 to 30 min.
* Used for diagnosis when cancer is suspected or to 3. Pour off supernatant
provide evidence of metastatic disease 4. Prepare two smears for the Papanicolaou technique
* Performed in conjunction with Papanicolaou smear from the sediment.
preparation 5. Pour a small amount of fixative directly into the test
* Sediments from CSF, urine, etc. can be transformed tube containing the sediment to coagulate it and let it
into solid tissue stand for 15 to 30 minutes.
* Provides evidence for metastatic cancer 6. Wrap the recovered sediment using lens paper or
- Cancer: Continuous changing of cells particularly their gauze.
number 7. Immerse in the fixative for 6 to 24 hours depending
- Metastasis: Infective to other organs on the size of the coagulated sample.
* Pap’s smear/Papanicolaou smear 8. Perform routine procedure for dehydration, clearing,
- Chromatic staining for metachromatic tissues infiltration, embedding, sectioning and staining.
- For vaginal smear
- Utero vaginal smear The cellient automated cell block system
* The cellient automated cell block system concentrates,
Specimens used for cell blocking processes, & embeds loose cells into a paraffin block
* FNAC/FNAB ready for sectioning. User variability is minimized & tech
* Sputum time is reduced
- Inner portion of respiratory tract * Cells are concentrated into a well in the cassette by
* Urine vacuum, & subsequent washes with alcohol & xylene fix
* Effusion fluids & dear the specimen
- Cell culture * The cell button is then infiltrated with paraffin in the
* Lavages & washings same cassette. The entire process takes approximately
- Lavativa 45 minutes

* Dilution formula Limitations

- V1V2 = C2V2 1. Increase turn around time
2. Excess material is required to obtain a good quality
Materials suitable for the cell block procedure cellular pellet
* Sputum containing cells in thick mucus. 3. The risk of losing cytological material during tissue
* Effusions in which cells are growing as a state of cell processing or sectioning is another drawback because of
culture. the small size of the specimen
* Washings containing cell clusters, which are 4. All CB techniques are labor intensive & demanding
mechanically exfoliated. 5. Not all specimens are suitable for CB preparation
* Fluids should be collected in an anticoagulant
(potassium oxalate, heparin or sodium citrate-citric acid) Definition of cell block
when possible * Technique of “blocking” cells on something to hold it
- 2 ml anticoagulant for each 100 ml of fluid together & maintain its shape
* Samples should be processed in the fresh state * A method of preparing cytological materials so that it
promptly can be processing, sectioning, staining & view in
histologic section
Gross examination
* Describing the general characteristics of the sample Purpose
and volume received * Todo special stain (congo stain, mucicarmine stain)
- Descriptive terms: blood-tinged, clear, yellow, amber, * Morphology evaluation
frothy, mucinous * To do immunohistochemistry
* Molecular diagnostic

Types of cell block

* Plasma thrombin
* Histo gel
* Agar method
 Plasma thrombin Histo-gel method
* To enmesh the cellular materials in a clot * Used for cytology specimens with a predominance of
* Procedure: individually scattered cells
* Involves steps to concentrate the cells of interest along
the plane parallel to the cutting surface of the cell block
* Example:
- Cell block preparations of cervical ThinPreps (less
cellular & may contain only scattered individual abnormal
cells)
* Procedures

Agar gel method

* The concentrated sediment is supported by the agar.
* More time consuming
* Agar solidified below 50oC
* Creates excellent block (Various cells distributed in a
layers for optimal visualization)
*Procedure:

Advantage of cell block

* Storage of cell blocks are easily compared to unstained
smear
* Slides more readily interpretable by histopathologist
* Availability of cell blocks facilitates more section
* Reproducible
* Simple
* Readily available in routine lab
* Concentrated in small area of slide
Disadvantages
* Sparse cellularity
* Time consuming (compared to routine smears)
* Distortion artifacts